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Post-Transplant Events

HLA-C mismatch is associated with inferior survival after unrelated donor non-myeloablative hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 37, pages 845–850 (2006)Cite this article

Abstract

HLA-C matching is an important determinant of outcome after myeloablative unrelated donor (URD) hematopoietic stem cell transplantation. However, its importance in non-myeloablative stem cell transplantation (NST) is not known. We report a retrospective analysis of 111 patients who underwent URD NST, of whom 78 were 10/10 matched at HLA-A, B, C, DRB1, DQB1 and 33 were mismatched at one or more HLA-C antigen/allele (24 HLA-C only; nine HLA-C+other locus mismatch). Patients were conditioned with busulfan (0.8 mg/kg/day i.v. × 4 days) and fludarabine (30 mg/m2/day i.v. × 4 days). Graft-versus-host disease prophylaxis included cyclosporine/prednisone- or tacrolimus/mini-methotrexate-based regimens. HLA-C disparity did not impair engraftment. Median marrow donor chimerisms were ⩾90% donor at day+30 and +100 in both groups. Overall survival at 2 years was 30% in HLA-C-mismatched and 51% in 10/10-matched patients (P=0.008). In Cox regression, HLA-C mismatch was an independent predictor of death (hazard ratio 1.85, P=0.04). Treatment-related mortality was higher in the HLA-C-mismatched group: 48 versus 16% (P=0.0001). Cumulative relapse incidence was 35% in the HLA-C-mismatched and 55% in the 10/10-matched cohort, P=0.09. HLA-C mismatch is associated with inferior survival after URD NST.

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Acknowledgements

This study was supported, in part, by the Ted and Eileen Pasquarello Leukemia Research Fund, and NIH Grant 5 PO1 HL070149-03.

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Authors and Affiliations

  1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    V T Ho, D Liney, C Cutler, S J Lee, J H Antin, R J Soiffer & E P Alyea

  2. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA

    V T Ho, E Milford, C Cutler, S J Lee, J H Antin, R J Soiffer & E P Alyea

  3. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA

    H T Kim

  4. Department of Medical Oncology, St Bartholomew's Hospital, London, UK

    J Gribben

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  1. V T Ho
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  2. H T Kim
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  3. D Liney
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  4. E Milford
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  6. C Cutler
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  7. S J Lee
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  8. J H Antin
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  9. R J Soiffer
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  10. E P Alyea
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Corresponding author

Correspondence to V T Ho.

Additional information

Results of this study were presented, in part, at the meeting of American Society of Blood and Marrow Transplantation, Keystone, CO, February 2005, and the meeting of the American Society of Hematology, Atlanta, GA, December 2005.

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Ho, V., Kim, H., Liney, D. et al. HLA-C mismatch is associated with inferior survival after unrelated donor non-myeloablative hematopoietic stem cell transplantation. Bone Marrow Transplant 37, 845–850 (2006). https://doi.org/10.1038/sj.bmt.1705315

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